Saint Mary’s Hospital

Gynaecology Services

Saint Mary’s Hospital

Laparoscopic Sterilisation

Information For Patients

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Contents

Welcome .............................................................................................. 3

What is Laparoscopic Sterilisation? ................................................ 3

What does the operation involve? .............................................. 4

What are the risks of Laparoscopic Sterilisation? ....................... 5

What are the benefits? ................................................................ 6

Are there any alternatives to surgery? ........................................ 6

Consent ........................................................................................... 6

How can I prepare myself for the operation? ............................. 6

How long will the procedure take? .............................................. 7

What can I expect after my operation? ....................................... 8

Will I have a scar? ........................................................................... 9

What arrangements should I make for going home? ................. 9

When can I return to my normal activities? ................................ 9

When can I expect a period? .................................................... 10

Will I need a follow-up appointment? ..................................... 11

Useful contact numbers ............................................................ 11

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Welcome to the Gynaecology Services at Saint Mary’s Hospital

This leaflet aims to give you some general information about a

laparoscopic sterilisation, and help to answer some of the

questions you may have. It is intended as a guide and there will

be an opportunity for you to talk to your nurse and doctor

about your care and treatment.

What is Laparoscopic Sterilisation?

It is a minor surgical procedure performed under a general

anaesthetic, which provides permanent contraception by

blocking the fallopian tubes, usually with metal clips. This

prevents the egg from the ovaries travelling to the womb

(uterus) and also prevents the egg and sperm from meeting, so

there can be no fertilization or resulting pregnancy.

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What does the operation involve?

A laparoscope is a small flexible tube (telescope) which contains

a fibreoptic light and camera. The camera relays images of the

inside of the abdomen or pelvis to a television monitor. Small

incisions (cuts) are made near the belly button (umbilicus), and

possibly on either side of the lower part of the abdomen

allowing the laparoscope to be inserted. Carbon dioxide gas is

pumped into the abdomen which expands allowing the pelvic

organs to be seen clearly. Metal clips are applied to both

fallopian tubes.

Fallopian tubes are cut or blocked to stop the egg

travelling from the ovary to the uterus.

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If for any reason it is not possible to perform the operation in

this way, it may be necessary to make a slightly larger incision

along the bikini line to allow the operation to be performed

safely (a mini-laparoscopy).

What are the risks of a Laparoscopic Sterilisation?

Minor complications occur in 1 to 2 cases in every 100. These

include:

• Post-operative infection.

• Minor bleeding and bruising around the site of the incision

(cut).

• Nausea and vomiting.

• Failure rate of 1:200. If the sterilisation should fail there is

an increased risk of the pregnancy implanting in the

fallopian tube. This is known as an ectopic pregnancy.

Major complications following a laparoscopy are rare. They

occur in an estimated 1 in every 1,000 cases.

They include:

• Not being able to perform a laparoscopy and needing to

perform a mini-laparotomy.

• Damage to an organ, such as your bowel or bladder, which

could result in the loss of organ function.

• Damage to a major artery (blood vessel).

• Damage to the nerves in your pelvis.

• Complications arising from the use of carbon dioxide during

the procedure, such as the gas bubbles entering your veins

or arteries.

• A serious allergic reaction to the anaesthetic.

Further surgery is usually required to treat any major

complications.

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What are the benefits?

It is a permanent method of contraception and means that

intercourse can be enjoyed without fear of unwanted

pregnancy.

Are there any alternatives to surgery?

The decision to have a sterilisation is usually made because you

have tried all other methods of contraception, and find them

unsuitable or are unable to use them due to medical problems.

If this is not the case, and you wish to discuss alternative

contraception or male sterilisation, please inform a member of

staff.

Consent

We must by law obtain your written consent to any operation.

Staff will explain the risks, benefits and any alternatives. You

will then be asked to sign a consent form. If you are unsure

about any aspect of the treatment proposed, please do not

hesitate to speak to a member of staff.

It is extremely important that you are certain you do not ever

want any more children before you have this operation.

How can I prepare myself for the operation

Please make sure your decision to have the operation has not

been taken during a time of emotional stress, for example,

recent childbirth or marital stress, and that there are no

circumstances (such as divorce, remarriage or death of a child)

where you would desire further pregnancies. Research has

shown that you are more likely to have regrets later on if you

are under 30 or if you do not have children already. You need

to be very sure about your decision. No-one can force you to

have the operation if you do not want to.

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Ensure you fully understand the procedure by highlighting any

questions or worries. There is a section in this booklet that you

may wish to use to write down your questions and take with

you on your admission to hospital so that you can discuss any of

your concerns.

It is very important that you continue with your chosen method

of contraception until the period following your operation. A

pregnancy test will be taken on the morning of surgery,

however, it may not show up a very early pregnancy.

Organise your home circumstances, so you do not have to worry

about housework, shopping, childcare etc.

It is advisable to bring an overnight bag toiletries and sanitary

towels with you, just in case you need to stay in hospital. You

should have a bath or shower on the morning of your

operation. Please remove any body piercings and nail varnish

from fingers and toes. Valuables and jewellery should be left at

home.

You will be asked to ring the ward the evening before your

operation to confirm that a bed is available - please ask the

nurse to confirm whether you will be going to theatre in the

morning or afternoon and what time you need to starve from.

It is very important that you do not have anything to eat or

drink for at least 6 hours before your operation. This includes

sweets and chewing gum. You may be allowed water up to 2

hours before surgery - your nurse will confirm this.

How long does the procedure take?

It will normally take between 20-30 minutes. You should return

to the ward after 1-2 hours following a short time in the

recovery room.

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What can I expect after my operation?

• Pain/discomfort

It is normal to expect some mild abdominal, leg or shoulder-tip

pain after your operation. You may be prescribed some pain

relief to take home. Your nurse will explain what they are and

how often to take them. If you are not given any pain relief on

discharge, please use over the counter pain killers, such as

paracetamol or ibuprofen based products, but always read the

label/instructions before taking them.

Wind pain is a common problem experienced by women

following a laparoscopy, due to the gas put into the abdomen.

Use of a heat pack or drinking peppermint tea can help, along

with keeping mobile.

• Vaginal bleeding

It is common to have some mild vaginal bleeding for up to

seven days after your operation. Do not use tampons during this

period, only sanitary towels. Tampons may increase your risk of

developing a mild infection. If you feel your bleeding is very

heavy, prolonged or has an offensive smell, please seek advice

from your GP.

• Wounds

Your wounds will either be closed with a very small suture

(stitch) or with surgical glue. Sutures will usually dissolve within

10-14 days. If they do not and are causing discomfort please

seek advice from your GP or Practice Nurse who may be able to

remove them for you. Glued sites may be left to heal and no

intervention is required.

Some oozing from the wounds may be noted for the first 24

hours after your operation and a dry dressing may be applied.

After this time they should be left exposed and kept clean and

dry. If the oozing continues and/or the areas become red,

inflamed or smelly, please seek advice from your GP, as you may

have developed a mild infection. Always make sure you wash

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your hands before and after caring for your wounds.

You may bathe and/or shower as normal - it does not matter if

you get the sutures or glue wet. However, please ensure that

you dry your wounds thoroughly with a clean towel afterwards.

Will I have a scar?

The incisions made are very small and the scars will barely be

visible after a few months.

What arrangements should I make for going home?

The operation is usually performed as a daycase, so you should

make arrangements for someone to pick you up from hospital

and stay with you overnight. Your nurse should be able to give

you an approximate time for your discharge home.

When can I return to my normal activities?

This advice can only be used as a guide as your recovery from

the operation will be specific to you as an individual. If you

have had a mini-laparotomy your recovery may take longer

than the suggested guide below.

It is normal to feel tired for a few days after your operation,

and you may need to rest.

• Work

Following a laparoscopy you can normally return to work within

7 days. (2-4 weeks for laparotomy). Most work places allow you

to self-certify for up to 7 days, but please let staff know if this is

a problem and you require a sick note.

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• Exercise and Lifting

Avoid heavy lifting, housework, and strenuous exercise for 7

days (4-6 weeks for laparotomy). After this time you should be

able to ease yourself gently back into your exercise programme.

You must not go swimming until your wounds have healed and

any vaginal discharge has stopped.

• Driving

You must not drive for at least 24 hrs and only then when you

feel comfortable wearing a seatbelt and can perform an

emergency stop without any abdominal discomfort (6 weeks for

laparotomy). Please contact your insurance company for

confirmation.

• Sex

Do not resume having sexual intercourse until any vaginal

bleeding has stopped and you feel ready and comfortable to do

so. Please ensure that you continue to use carefully your chosen

method of contraception until your next period.

When can I expect a period?

Every woman is different regarding how soon after the

operation to expect a period, however sometime in the next 4-6

weeks is considered usual.

Often this first period may be heavier or lighter than normal,

but should return to normal with 2-3 months. If you have not

had a period within 6-8 weeks, please contact your GP or the

hospital.

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Will I need a follow up appointment?

Routine follow up appointments are not usually necessary at

the hospital. A letter will be sent to your GP to inform them of

your operation and you will be able to attend the surgery if you

have any concerns.

Saint Mary’s Hospital contact numbers:

Should you require any additional information or help please

contact:

Gynaecology Wards:

0161 276 6105 (24 hours a day), or

0161 276 6517 or

0161 701 0048

(24 hours)

Emergency Gynaecology Unit (EGU)

0161 276 6204

(Monday to Friday 8.00 am–5.00 pm)

Other useful contact numbers and websites:

Women’s Health Concern - 01628 478473

www.womens-health-concern.org.uk

NHS Direct - 0845 4647

www.nhsdirect.nhs.uk

NHS Choices

www.nhs.uk

No Smoking Policy

The NHS has a responsibility for the nation’s health.

Protect yourself, patients, visitors and staff by adhering to our

no smoking policy. Smoking is not permitted within any of our

hospital buildings or grounds.

The Manchester Stop Smoking Service can be contacted on

Tel: (0161) 205 5998 (www.stopsmokingmanchester.co.uk).

Translation and Interpretation Service

Do you have difficulty speaking or understanding English?

☎ 0161 276 6202/6342

Produced by the Gynaecology Department

Saint Mary’s Hospital

Oxford Road

Manchester

M13 9WL

© Copyright to Central Manchester University Hospitals NHS Foundation Trust

TIG 11/99 Produced April 2011 Review Date April 2013 (SF Taylor CM3038)